Abstract Breast cancer is one of the most commonly encountered types of malignancy during pregnancy. Here, we review the most recent data with regards to this special patient population. Current evidence shows that it is appropriate for oncologists to treat these patients carefully with a coordinated multidisciplinary approach.
{"title":"Breast Cancer and Pregnancy: A Review","authors":"F. Ting, N. Cabaya, B. D. Guzman","doi":"10.1055/s-0041-1729348","DOIUrl":"https://doi.org/10.1055/s-0041-1729348","url":null,"abstract":"Abstract Breast cancer is one of the most commonly encountered types of malignancy during pregnancy. Here, we review the most recent data with regards to this special patient population. Current evidence shows that it is appropriate for oncologists to treat these patients carefully with a coordinated multidisciplinary approach.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"060 - 063"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1729348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49573146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective The aim of this study was to evaluate the efficacy and cardiotoxicity profile, and to reduce the extend of breast cancer surgery in primary systemic therapy (PST) HER2/neu–positive operable breast cancer patients. Materials and Methods A total of 152 patients diagnosed from 2010 to 2015 were included in the study. The PST consisted of a sequential regimen of taxanes and anthracyclines plus trastuzumab. The clinical and pathological responses and the type of breast cancer surgery were evaluated and correlated with clinical and biological factors. The cardiotoxicity profile and long-term benefits were analyzed. Results The median patient age was 47 (37–67) years, with T2 and T3 67 (44.1%) and 85 (55.9%), respectively. Axillary lymph node breast cancer at diagnosis N0 was 104 (68.4%) and N1 and N2 were 28.9% and 2.6%, respectively. A total of 95.7% of patients had nonspecific type of breast cancer, 67% of tumors were hormonal receptor–negative, 75.5% were grade III, 100% Ki67 > 20%, and 90% of tumors were confirmed to be HER2/neu–positive through immunohistochemistry. Following PST, pathological complete response (pCR) rate was achieved in 44.7% evaluable patients. The pCR rate was higher in HR-negative (93.1% vs. 6.9%) cancer and in grade III (86.2%) than in grade I and II (13.8%) cancer; only 75.5% of complete response (CR) on ultrasound and magnetic resonance imaging were also CR on pathology results. Breast conserving surgery was performed in 41.4%. Regarding type of chemotherapy, there were no significant differences between chemotherapy with anthracycline backbone or taxanes to achieved pathological complete response. Despite that, we were unable to demonstrate an association between pCR and better DFS with p = 0.096; HR 5.7 95.0% CI (0.73–45.52). Patients who are hormonal receptor positive tend to have lower disease-free survival (DFS) than those who are hormonal receptor negative; HR = 6.34, 95.0% CI (1.54–26.00) and p = 0.010. Five years DFS was higher for those who achieved pCR compare with those who did not. Even in this research we failed to show it is statistically significant. Conclusion A sequential regimen of taxanes and anthracyclines plus trastuzumab was effective with high pCR rates and increases the possibility to do breast conservation surgery and had tolerable cardiotoxicity profile.
摘要目的本研究旨在评估原发性全身治疗(PST) HER2/新阳性可手术乳腺癌患者的疗效和心脏毒性，并减少乳腺癌手术的范围。材料与方法本研究共纳入2010 - 2015年诊断的152例患者。PST包括紫杉烷和蒽环类药物加曲妥珠单抗的顺序方案。评价两组患者的临床、病理反应及乳腺癌手术类型，并与临床、生物学因素进行相关性分析。分析了心脏毒性概况和长期效益。结果患者年龄中位数为47(37 ~ 67)岁，其中T2和T3分别为67(44.1%)和85(55.9%)岁。腋窝淋巴结乳腺癌诊断为N0时为104例(68.4%)，N1和N2分别为28.9%和2.6%。共有95.7%的患者为非特异性乳腺癌，67%的肿瘤为激素受体阴性，75.5%的肿瘤为III级，100%的Ki67 > 20%， 90%的肿瘤通过免疫组织化学证实HER2/ new阳性。PST后，44.7%的可评估患者达到病理完全缓解(pCR)率。hr阴性肿瘤(93.1% vs. 6.9%)和III级肿瘤(86.2%)的pCR率高于I级和II级肿瘤(13.8%);超声和磁共振完全缓解(CR)病理完全缓解者仅为75.5%。保乳手术占41.4%。在化疗类型方面，蒽环类主链化疗与紫杉烷类化疗在病理完全缓解方面无显著差异。尽管如此，我们无法证明pCR与更好的DFS之间存在关联(p = 0.096);Hr 5.7, 95.0% ci(0.73-45.52)。激素受体阳性患者的无病生存期(DFS)往往低于激素受体阴性患者;HR = 6.34, 95.0% CI (1.54 ~ 26.00)， p = 0.010。获得pCR的患者的5年DFS高于未获得pCR的患者。即使在这项研究中，我们也没有证明它在统计上是显著的。结论紫杉烷类、蒽环类药物加曲妥珠单抗序贯治疗是有效的，pCR率高，增加了保乳手术的可能性，心脏毒性谱可耐受。
{"title":"Primary Systemic Therapy for HER2/Neu-Positive Operable Breast Cancer Increases the Number of Breast-Conserving Surgery and Disease-Free Survival: Retrospective Cohort Analysis at Single Institution","authors":"Y. Azhar, H. Agustina, B. Hernowo","doi":"10.1055/s-0041-1729481","DOIUrl":"https://doi.org/10.1055/s-0041-1729481","url":null,"abstract":"Abstract Objective The aim of this study was to evaluate the efficacy and cardiotoxicity profile, and to reduce the extend of breast cancer surgery in primary systemic therapy (PST) HER2/neu–positive operable breast cancer patients. Materials and Methods A total of 152 patients diagnosed from 2010 to 2015 were included in the study. The PST consisted of a sequential regimen of taxanes and anthracyclines plus trastuzumab. The clinical and pathological responses and the type of breast cancer surgery were evaluated and correlated with clinical and biological factors. The cardiotoxicity profile and long-term benefits were analyzed. Results The median patient age was 47 (37–67) years, with T2 and T3 67 (44.1%) and 85 (55.9%), respectively. Axillary lymph node breast cancer at diagnosis N0 was 104 (68.4%) and N1 and N2 were 28.9% and 2.6%, respectively. A total of 95.7% of patients had nonspecific type of breast cancer, 67% of tumors were hormonal receptor–negative, 75.5% were grade III, 100% Ki67 > 20%, and 90% of tumors were confirmed to be HER2/neu–positive through immunohistochemistry. Following PST, pathological complete response (pCR) rate was achieved in 44.7% evaluable patients. The pCR rate was higher in HR-negative (93.1% vs. 6.9%) cancer and in grade III (86.2%) than in grade I and II (13.8%) cancer; only 75.5% of complete response (CR) on ultrasound and magnetic resonance imaging were also CR on pathology results. Breast conserving surgery was performed in 41.4%. Regarding type of chemotherapy, there were no significant differences between chemotherapy with anthracycline backbone or taxanes to achieved pathological complete response. Despite that, we were unable to demonstrate an association between pCR and better DFS with p = 0.096; HR 5.7 95.0% CI (0.73–45.52). Patients who are hormonal receptor positive tend to have lower disease-free survival (DFS) than those who are hormonal receptor negative; HR = 6.34, 95.0% CI (1.54–26.00) and p = 0.010. Five years DFS was higher for those who achieved pCR compare with those who did not. Even in this research we failed to show it is statistically significant. Conclusion A sequential regimen of taxanes and anthracyclines plus trastuzumab was effective with high pCR rates and increases the possibility to do breast conservation surgery and had tolerable cardiotoxicity profile.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"089 - 095"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1729481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44168884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction A retrospective clinical study was performed to identify the characteristics of patients with lung cancer treated with integrative cancer treatment in addition to conventional medicine. Materials and Methods We reviewed medical records for lung cancer patients who visited a single integrative setting in Rome, Italy. A total of 57 patients were included, and the majority had advanced-stage cancer. All of them underwent integrative therapy with nutrition and phytotherapy indications. The diet was designed to reduce most of possible factors promoting cancer proliferation, inflammation, and obesity. Foods with anti-inflammatory, prebiotic, antioxidant, and anticancer properties had been chosen. Herbal supplements with known effects on lung cancer were prescribed. In particular, astragal, apigenine, fucosterol, polydatin, epigallocatechin gallate, cannabis, curcumin, and inositol were used. Furthermore, medical mushrooms and other substances were used to improve the immune system and to reduce chemotherapy side effects. Five key parameters have been evaluated for 2 years starting at the first surgery: nutritional status, immune status, discontinuation of therapy, quality of life, and prognosis of the disease. Results A relevant improvement in parameters relative to nutritional status, immune status, and quality of life has been observed after integrative therapy compared with the same parameters at the first medical visit before starting such approach. Conclusion The results suggest that integrative therapy may have benefits in patients with lung cancer. Even though there are limitations, the study suggests that integrative therapy could improve nutritional status and quality of life, with possible positive effect on overall survival.
{"title":"Integrative Treatment of Lung Cancer Patients: Observational Study of 57 Cases","authors":"L. Anelli, A. Di Nardo, M. Bonucci","doi":"10.1055/s-0040-1722380","DOIUrl":"https://doi.org/10.1055/s-0040-1722380","url":null,"abstract":"Abstract Introduction A retrospective clinical study was performed to identify the characteristics of patients with lung cancer treated with integrative cancer treatment in addition to conventional medicine. Materials and Methods We reviewed medical records for lung cancer patients who visited a single integrative setting in Rome, Italy. A total of 57 patients were included, and the majority had advanced-stage cancer. All of them underwent integrative therapy with nutrition and phytotherapy indications. The diet was designed to reduce most of possible factors promoting cancer proliferation, inflammation, and obesity. Foods with anti-inflammatory, prebiotic, antioxidant, and anticancer properties had been chosen. Herbal supplements with known effects on lung cancer were prescribed. In particular, astragal, apigenine, fucosterol, polydatin, epigallocatechin gallate, cannabis, curcumin, and inositol were used. Furthermore, medical mushrooms and other substances were used to improve the immune system and to reduce chemotherapy side effects. Five key parameters have been evaluated for 2 years starting at the first surgery: nutritional status, immune status, discontinuation of therapy, quality of life, and prognosis of the disease. Results A relevant improvement in parameters relative to nutritional status, immune status, and quality of life has been observed after integrative therapy compared with the same parameters at the first medical visit before starting such approach. Conclusion The results suggest that integrative therapy may have benefits in patients with lung cancer. Even though there are limitations, the study suggests that integrative therapy could improve nutritional status and quality of life, with possible positive effect on overall survival.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"064 - 075"},"PeriodicalIF":0.0,"publicationDate":"2021-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42047361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kurniawan, D. A. Halim, A. Giselvania, N. Sutandyo, S. S. Panigoro, A. Adisasmita, R. D. Hatma
Abstract Introduction Breast cancer is the most prevalent cancer found in women. The World Health Organization declared the coronavirus disease 2019 (COVID-19) as a public health emergency of international concern. Delaying treatment was associated with mortality. The aim is to evaluate breast cancer management during the pandemic. Methods We searched articles evaluating the management of breast cancer in the midst of COVID-19 outbreak, by searching in PubMed, PubMed Central, and Oncology Society related websites. We only included articles discussing adult breast cancer management in COVID-19 era. The two reviewers screened the titles and abstracts. Results Around 124 articles were found through the searching process. Eight observational trials, two review articles, six guidelines or recommendations, and one letter to the editor were included in final review. It was concluded that breast cancer posed a risk to contract COVID-19. Newly suspected breast cancer could be deferred for screening or diagnosis, except for special breast cancer cases with bleeding, invasive, and complicated tumors. The benefit of radiotherapy option in every case should be carefully weighed against the risk of infection. Oral chemotherapy and hormonal therapy drugs were preferred to be given than intravenous chemotherapy. The scheduled chemotherapy could be adjusted to reduce hospital visit. Each breast cancer patient is different, so they should be discussed in multidisciplinary team consisting of surgical, radiation, and medical oncologists, pathologist, radiologist, palliative care people, nurses, nutritionist, and others related to the field. Conclusion The International Oncology Society has released recommendations for breast cancer during COVID-19 pandemic but there is still questionable-quality evidence.
{"title":"Breast Cancer Management during Coronavirus Disease 2019 Pandemic: A Literature Review","authors":"A. Kurniawan, D. A. Halim, A. Giselvania, N. Sutandyo, S. S. Panigoro, A. Adisasmita, R. D. Hatma","doi":"10.1055/s-0040-1722809","DOIUrl":"https://doi.org/10.1055/s-0040-1722809","url":null,"abstract":"Abstract Introduction Breast cancer is the most prevalent cancer found in women. The World Health Organization declared the coronavirus disease 2019 (COVID-19) as a public health emergency of international concern. Delaying treatment was associated with mortality. The aim is to evaluate breast cancer management during the pandemic. Methods We searched articles evaluating the management of breast cancer in the midst of COVID-19 outbreak, by searching in PubMed, PubMed Central, and Oncology Society related websites. We only included articles discussing adult breast cancer management in COVID-19 era. The two reviewers screened the titles and abstracts. Results Around 124 articles were found through the searching process. Eight observational trials, two review articles, six guidelines or recommendations, and one letter to the editor were included in final review. It was concluded that breast cancer posed a risk to contract COVID-19. Newly suspected breast cancer could be deferred for screening or diagnosis, except for special breast cancer cases with bleeding, invasive, and complicated tumors. The benefit of radiotherapy option in every case should be carefully weighed against the risk of infection. Oral chemotherapy and hormonal therapy drugs were preferred to be given than intravenous chemotherapy. The scheduled chemotherapy could be adjusted to reduce hospital visit. Each breast cancer patient is different, so they should be discussed in multidisciplinary team consisting of surgical, radiation, and medical oncologists, pathologist, radiologist, palliative care people, nurses, nutritionist, and others related to the field. Conclusion The International Oncology Society has released recommendations for breast cancer during COVID-19 pandemic but there is still questionable-quality evidence.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"052 - 059"},"PeriodicalIF":0.0,"publicationDate":"2021-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44345787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Extraskeletal mesenchymal chondrosarcoma (ESMC) metastasizing to the pancreas in isolation is a rare occurrence. We report a 49-year-old gentleman who had undergone excision of an ESMC of the thigh in 2009 and presented with sudden onset abdominal pain and icterus in 2019. Radiological imaging revealed calcified mass of the pancreas with multiple nodules with extension into the adipose tissue. Distal pancreatectomy was performed and the pathology revealed a bimorphic tumor composed of undifferentiated round blue cells with abrupt transition to hyaline cartilage, typical of mesenchymal chondrosarcoma. To the best of our knowledge, there are only seven prior cases of metastatic ESMC of the pancreas in the English literature. Surgical intervention appears to be the preferred modality of treatment for metastatic pancreatic tumors. These patients may have long latency period before metastasizing and seem to have a good survival period post excision.
{"title":"Metastatic Extraskeletal Mesenchymal Chondrosarcoma of the Pancreas: Report of an Unusual Case with Review of Literature","authors":"S. Shah, A. Parameswaran, P. Reddy","doi":"10.1055/s-0040-1722807","DOIUrl":"https://doi.org/10.1055/s-0040-1722807","url":null,"abstract":"Abstract Extraskeletal mesenchymal chondrosarcoma (ESMC) metastasizing to the pancreas in isolation is a rare occurrence. We report a 49-year-old gentleman who had undergone excision of an ESMC of the thigh in 2009 and presented with sudden onset abdominal pain and icterus in 2019. Radiological imaging revealed calcified mass of the pancreas with multiple nodules with extension into the adipose tissue. Distal pancreatectomy was performed and the pathology revealed a bimorphic tumor composed of undifferentiated round blue cells with abrupt transition to hyaline cartilage, typical of mesenchymal chondrosarcoma. To the best of our knowledge, there are only seven prior cases of metastatic ESMC of the pancreas in the English literature. Surgical intervention appears to be the preferred modality of treatment for metastatic pancreatic tumors. These patients may have long latency period before metastasizing and seem to have a good survival period post excision.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"152 - 155"},"PeriodicalIF":0.0,"publicationDate":"2021-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42073996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Ahmad, K. Chufal, C. P. Bhatt, A. Miller, R. Bajpai, R. Chowdhary, A. Pahuja, Akanksha Chhabra, M. Gairola
Abstract Introduction This study investigates the optimal target delineation protocol stratified by treatment planning technique in patients undergoing whole breast radiotherapy after breast conservation surgery. Materials and Methods Target delineation using Tangent (RTOG 0413 Whole Breast Irradiation Protocol), European SocieTy for Radiotherapy and Oncology (ESTRO), and Radiation Therapy & Oncology Group (RTOG) guidelines was performed on 10 randomly selected treatment planning computed tomography datasets of patients with left-sided breast cancer. An objective plan quality metric (PQM) scoring schema was defined and communicated to the medical physicist prior to commencement of treatment planning. Treatment planning was performed using field-in-field (FiF) intensity modulated radiotherapy technique (IMRT), inverse IMRT, and volumetric modulated arc therapy (VMAT), for each type of target. Two-way repeated measures, analysis of variance was utilized to compare the total PQM scores and dosimetric variables, stratified by treatment planning method. Results Total PQM score of plans for FiF, IMRT, and VMAT revealed that Tangent and ESTRO delineations were equivalent regardless of planning technique (Tangent vs. ESTRO for FiF, p = 0.099; Tangent vs. ESTRO for IMRT, p = 0.029; Tangent vs. ESTRO for VMAT, p = 0.438). Both delineation protocols were significantly superior to RTOG for all treatment planning techniques. Conclusion For all treatment planning techniques, ESTRO and Tangent delineation were equivalent and both achieved significantly higher scores than RTOG delineation.
摘要简介本研究探讨保乳手术后全乳放疗患者采用治疗计划技术分层的最佳靶点划定方案。材料与方法采用正切(RTOG 0413全乳房照射方案)、欧洲放射与肿瘤学会(ESTRO)和放射治疗与肿瘤学会(RTOG)指南对随机选择的10例左侧乳腺癌患者的治疗计划计算机断层扫描数据集进行靶点划定。制定客观计划质量度量(PQM)评分方案，并在治疗计划开始前与医学物理学家沟通。针对每种类型的靶标，采用场内场(FiF)调强放疗技术(IMRT)、逆调强放疗技术(逆调强放疗技术)和体积调制弧线治疗(VMAT)进行治疗计划。采用双向重复测量、方差分析比较PQM总分和剂量学变量，采用治疗计划法分层。结果FiF、IMRT和VMAT计划的PQM总评分显示，无论计划技术如何，切线和ESTRO描绘都是等效的(FiF的切线与ESTRO, p = 0.099;切线与ESTRO的IMRT, p = 0.029;切线vs. ESTRO的VMAT, p = 0.438)。两种划定方案在所有治疗计划技术上都明显优于RTOG。结论对于所有的治疗计划技术，ESTRO和正切描绘是相同的，两者的得分都明显高于RTOG描绘。
{"title":"Can the Choice of Radiotherapy Delivery Technique Influence Which Target Delineation Protocol to Use? A Plan-Quality-Based Analysis in Left Breast Cancer","authors":"I. Ahmad, K. Chufal, C. P. Bhatt, A. Miller, R. Bajpai, R. Chowdhary, A. Pahuja, Akanksha Chhabra, M. Gairola","doi":"10.1055/s-0040-1722428","DOIUrl":"https://doi.org/10.1055/s-0040-1722428","url":null,"abstract":"Abstract Introduction This study investigates the optimal target delineation protocol stratified by treatment planning technique in patients undergoing whole breast radiotherapy after breast conservation surgery. Materials and Methods Target delineation using Tangent (RTOG 0413 Whole Breast Irradiation Protocol), European SocieTy for Radiotherapy and Oncology (ESTRO), and Radiation Therapy & Oncology Group (RTOG) guidelines was performed on 10 randomly selected treatment planning computed tomography datasets of patients with left-sided breast cancer. An objective plan quality metric (PQM) scoring schema was defined and communicated to the medical physicist prior to commencement of treatment planning. Treatment planning was performed using field-in-field (FiF) intensity modulated radiotherapy technique (IMRT), inverse IMRT, and volumetric modulated arc therapy (VMAT), for each type of target. Two-way repeated measures, analysis of variance was utilized to compare the total PQM scores and dosimetric variables, stratified by treatment planning method. Results Total PQM score of plans for FiF, IMRT, and VMAT revealed that Tangent and ESTRO delineations were equivalent regardless of planning technique (Tangent vs. ESTRO for FiF, p = 0.099; Tangent vs. ESTRO for IMRT, p = 0.029; Tangent vs. ESTRO for VMAT, p = 0.438). Both delineation protocols were significantly superior to RTOG for all treatment planning techniques. Conclusion For all treatment planning techniques, ESTRO and Tangent delineation were equivalent and both achieved significantly higher scores than RTOG delineation.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"7 1","pages":"13 - 21"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44882098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wilson Bizimana, G. Akimana, Arthur Semedo Insumbo, H. Jerguigue, R. Latib, Y. Omor
Abstract Malignant melanoma of vagina is a rare condition. Its histogenesis has been debated and the positive diagnosis is based on immunohistochemistry. Pelvic magnetic resonance imaging remains the gold standard for assessing locoregional extension status and post-treatment surveillance of melanoma of vagina. The observation concerned a 53-year-old woman with no specific history who presented a primary malignant melanoma of vagina without secondary locations. To date, the case is the second one reported in the literature. Early diagnosis of the malignant melanoma of vagina may improve patient survival because late diagnoses are punctuated by poor prognosis. We have presented epidemiological with etiopathogenic characteristics and described all imaging features to stage the tumor and to conduct the appropriate treatment.
{"title":"Primary Malignant Melanoma of the Vagina without Metastasis: A Rare Case and Review of Literature","authors":"Wilson Bizimana, G. Akimana, Arthur Semedo Insumbo, H. Jerguigue, R. Latib, Y. Omor","doi":"10.1055/s-0040-1722110","DOIUrl":"https://doi.org/10.1055/s-0040-1722110","url":null,"abstract":"Abstract Malignant melanoma of vagina is a rare condition. Its histogenesis has been debated and the positive diagnosis is based on immunohistochemistry. Pelvic magnetic resonance imaging remains the gold standard for assessing locoregional extension status and post-treatment surveillance of melanoma of vagina. The observation concerned a 53-year-old woman with no specific history who presented a primary malignant melanoma of vagina without secondary locations. To date, the case is the second one reported in the literature. Early diagnosis of the malignant melanoma of vagina may improve patient survival because late diagnoses are punctuated by poor prognosis. We have presented epidemiological with etiopathogenic characteristics and described all imaging features to stage the tumor and to conduct the appropriate treatment.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"7 1","pages":"45 - 48"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44472215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jasmeen Kaur, Amarvir Kaur, R. Punia, Harish Dsari
Abstract Introduction Stomach is the most common primary site of signet ring cell adenocarcinoma unlike breast or pancreas. The distant metastasis is commonly seen in peritoneum, liver, and lungs. Few cases have been reported on metastasis in pericardial fluid with presentation of cardiac tamponade. However, to the best of my knowledge, myocardium is one of the rarest sites of distant metastasis. Case Report A 26-year-old male had abdominal pain at home and was brought dead to the hospital. The postmortem examination was done, and heart was sent for histopathological report. The gross examination of heart, lungs, liver, kidneys, and spleen were unremarkable and on microscopy, sections examined from lung and left ventricular wall showed infiltration by a tumor composed of signet ring cells and few glands in the background of the mucinous material and the primary site of tumor was suggested to be stomach and rectum, whereas sections examined from liver, kidneys and spleen did not show any significant pathological change or any metastatic deposit. Conclusion Distant metastasis of signet ring cell carcinoma is mostly seen in peritoneum, liver, and lungs. So, to conclude myocardium is the rarest site of distant metastasis. Therefore, the heart autopsy is of utmost importance to look for the cause of death and also important from the perspective of academic value.
{"title":"Metastatic Signet Ring Cell Adenocarcinoma—An Autopsy Finding in Myocardium: A Rare Case Report","authors":"Jasmeen Kaur, Amarvir Kaur, R. Punia, Harish Dsari","doi":"10.1055/s-0040-1722109","DOIUrl":"https://doi.org/10.1055/s-0040-1722109","url":null,"abstract":"Abstract Introduction Stomach is the most common primary site of signet ring cell adenocarcinoma unlike breast or pancreas. The distant metastasis is commonly seen in peritoneum, liver, and lungs. Few cases have been reported on metastasis in pericardial fluid with presentation of cardiac tamponade. However, to the best of my knowledge, myocardium is one of the rarest sites of distant metastasis. Case Report A 26-year-old male had abdominal pain at home and was brought dead to the hospital. The postmortem examination was done, and heart was sent for histopathological report. The gross examination of heart, lungs, liver, kidneys, and spleen were unremarkable and on microscopy, sections examined from lung and left ventricular wall showed infiltration by a tumor composed of signet ring cells and few glands in the background of the mucinous material and the primary site of tumor was suggested to be stomach and rectum, whereas sections examined from liver, kidneys and spleen did not show any significant pathological change or any metastatic deposit. Conclusion Distant metastasis of signet ring cell carcinoma is mostly seen in peritoneum, liver, and lungs. So, to conclude myocardium is the rarest site of distant metastasis. Therefore, the heart autopsy is of utmost importance to look for the cause of death and also important from the perspective of academic value.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"149 - 151"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43374457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Concurrent chemoradiotherapy is considered the standard treatment for the locally advanced cancer cervix (LACC). Radiotherapy is commonly administered by a three-dimensional conformal radiotherapy (3DCRT) approach followed by brachytherapy (BT). High dose rate (HDR) BT is commonly administered; however, several drawbacks exist including invasive technique, pain, requirement of anesthesia, and operative risks. We assessed the dosimetric difference between the HDR BT and the volumetric modulated arc therapy (VMAT) boost in those patients. Ten patients were selected retrospectively with LACC and all received whole pelvis radiotherapy followed by BT boost of 7 Gy in three fractions. The computed tomography (CT) image was transferred to the Varian system for the VMAT plan while the one with the applicator was transferred to the Sagi planning system and the high-risk clinical target volume (HR-CTV), bladder, rectum, sigmoid, and small bowel were delineate with a margin of 5 mm were added to the CTV to create the planning target volume (PTV). The D90 for the PTV in VMAT boost was lower than received by the HR-CTV in the BT boost. Mean volume of the PTV was higher than that of the HR-CTV. The D2cc was higher in VMAT for bladder, sigmoid, and rectum while the D2cc for the small bowel in BT was higher compared with the VMAT. The VMAT is an option that exists for patients who refuse BT or cannot tolerate it, or in case of nonavailability of BT or a nonworking machine.
{"title":"Dosimetric Comparison between High Dose Rate Brachytherapy Boost and Volumetric Arc Therapy Boost in Locally Advanced Cancer Cervix","authors":"H. Hegazy, Neamat Hegazy, M. Soliman, A. Elsaid","doi":"10.1055/s-0041-1729480","DOIUrl":"https://doi.org/10.1055/s-0041-1729480","url":null,"abstract":"Abstract Concurrent chemoradiotherapy is considered the standard treatment for the locally advanced cancer cervix (LACC). Radiotherapy is commonly administered by a three-dimensional conformal radiotherapy (3DCRT) approach followed by brachytherapy (BT). High dose rate (HDR) BT is commonly administered; however, several drawbacks exist including invasive technique, pain, requirement of anesthesia, and operative risks. We assessed the dosimetric difference between the HDR BT and the volumetric modulated arc therapy (VMAT) boost in those patients. Ten patients were selected retrospectively with LACC and all received whole pelvis radiotherapy followed by BT boost of 7 Gy in three fractions. The computed tomography (CT) image was transferred to the Varian system for the VMAT plan while the one with the applicator was transferred to the Sagi planning system and the high-risk clinical target volume (HR-CTV), bladder, rectum, sigmoid, and small bowel were delineate with a margin of 5 mm were added to the CTV to create the planning target volume (PTV). The D90 for the PTV in VMAT boost was lower than received by the HR-CTV in the BT boost. Mean volume of the PTV was higher than that of the HR-CTV. The D2cc was higher in VMAT for bladder, sigmoid, and rectum while the D2cc for the small bowel in BT was higher compared with the VMAT. The VMAT is an option that exists for patients who refuse BT or cannot tolerate it, or in case of nonavailability of BT or a nonworking machine.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"085 - 088"},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1729480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43024155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction External beam radiotherapy (EBRT) for head and neck (H&N) cancers continues to be delivered using varied technologies, ranging from the old two-dimensional conventional radiotherapy (2DRT) techniques to the modern three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT) in different centers in India. Due to limitations of spinal cord tolerance, electron and photon beams are combined in 2DRT and 3DCRT techniques for treating nodal volume of the H&N cases. However, many centers having modern technology practice IMRT/VMAT in place of electron beams. The purpose of this study is to analyze the role of combined electron and photon beams in radiotherapy of H&N cancers and its relevance in the modern era of IMRT/VMAT. Materials and Methods Data were collected through a survey conducted on cancer centers in India where radiotherapy is being given by 2DRT, 3DCRT, and IMR/VMAT for the treatment of head and neck cancers. Results The mean percentage of H&N (H&N) cases among all cases were 39.2% (standard deviation [SD]: 14.22), out of which 16.63% (SD: 20.83) were treated with a combination of photon and electron beams and 49.73% (SD: 37.41) were treated with IMRT/VMAT. The average percentage of H&N cases of government institutes was 38.39% (SD: 14.11) and that of private institutes was 40.14% (SD: 14.11). Patients treated with photon and electron combination and IMRT/VMAT were 22.19% (SD: 11.24) and 24.05% (SD: 23.99), respectively, in government institutes, and 10.29% (SD: 11.24) and 79.09% (SD: 26.75) in private institutes. Conclusion As per this study, we conclude that despite the availability of IMRT/VMAT, a combination of electron and photon beams is still relevant in India. Since a large proportion of the patients are still treated with the electron and photon combination, it is imperative that further studies on field–junction dosimetry should be conducted to ensure accurate dose delivery.
{"title":"Relevance of Combined Electron and Photon Beams in Radiotherapy of Head and Neck Cancers in the Era of Intensity-Modulated Radiotherapy","authors":"V. Pandey, K. Pandey, N. Pant, L. Verma","doi":"10.1055/s-0040-1718636","DOIUrl":"https://doi.org/10.1055/s-0040-1718636","url":null,"abstract":"Abstract Introduction External beam radiotherapy (EBRT) for head and neck (H&N) cancers continues to be delivered using varied technologies, ranging from the old two-dimensional conventional radiotherapy (2DRT) techniques to the modern three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT) in different centers in India. Due to limitations of spinal cord tolerance, electron and photon beams are combined in 2DRT and 3DCRT techniques for treating nodal volume of the H&N cases. However, many centers having modern technology practice IMRT/VMAT in place of electron beams. The purpose of this study is to analyze the role of combined electron and photon beams in radiotherapy of H&N cancers and its relevance in the modern era of IMRT/VMAT. Materials and Methods Data were collected through a survey conducted on cancer centers in India where radiotherapy is being given by 2DRT, 3DCRT, and IMR/VMAT for the treatment of head and neck cancers. Results The mean percentage of H&N (H&N) cases among all cases were 39.2% (standard deviation [SD]: 14.22), out of which 16.63% (SD: 20.83) were treated with a combination of photon and electron beams and 49.73% (SD: 37.41) were treated with IMRT/VMAT. The average percentage of H&N cases of government institutes was 38.39% (SD: 14.11) and that of private institutes was 40.14% (SD: 14.11). Patients treated with photon and electron combination and IMRT/VMAT were 22.19% (SD: 11.24) and 24.05% (SD: 23.99), respectively, in government institutes, and 10.29% (SD: 11.24) and 79.09% (SD: 26.75) in private institutes. Conclusion As per this study, we conclude that despite the availability of IMRT/VMAT, a combination of electron and photon beams is still relevant in India. Since a large proportion of the patients are still treated with the electron and photon combination, it is imperative that further studies on field–junction dosimetry should be conducted to ensure accurate dose delivery.","PeriodicalId":31357,"journal":{"name":"Asian Journal of Oncology","volume":"07 1","pages":"114 - 117"},"PeriodicalIF":0.0,"publicationDate":"2020-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1718636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42352995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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